John Glaser, Boston’s Top Hospital Geek, Talks About Obama’s Health IT Plan and Getting Booted from Catholic School

6/22/10

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investments doing very well. The second one is people who do [health information] exchange activities and interoperability stuff. The third will be secondary use of data; people beginning to look at EHR data to do post-market surveys or to support clinical research or do comparative effectiveness (which measures how well treatments for an ailment work alongside others). I think the fourth is uneven but, given the chronic disease problem, different ways to engage patients, whether in the workplace or through personal health records.

X: Glen Tullman, CEO of the medical software powerhouse Allscripts, recently said: “We are at the beginning of what we believe will be the single fastest transformation of any industry in U.S. history.” That sounds a bit audacious. Do you agree with that?

JG: I don’t know about a transformation of “any” industry in U.S. history. One thing is that the pace of transformation in many industries has picked up over the past couple of decades. Telecommunications has gone through amazing change. Retail has gone through amazing change. Financial services have gone through amazing changes, etcetera. So, I don’t know how to compare the economic and historical accuracy of that statement, but I do think we’re going to go through a hell of a lot of change in healthcare IT in a relatively short period of time. The pressures [to reduce costs in health care] are reaching breaking points. The funds are flowing in to do a variety of things. Increasingly, if you’re a doc or a hospital, it’s hard to avoid doing this electronic health records stuff, because it’s strategically and operationally perilous to not do it.

X: Watertown, MA-based Athenahealth (NASDAQ:ATHN) says it’s done surveys with doctors on Sermo.com that show most physicians surveyed think they’re going to lose money from EHR adoption. Do you think doctors will balk at buying electronic health records, despite the incentives available to them?

JG: No, I think they’ll buy. It kind of depends on how many hospitals and doctors’ offices you thought should be able to qualify for the incentives in 2011 and 2012. [Editor’s note: Doctors who qualify under EHR use standards called “Meaningful Use” can begin receiving Medicare and Medicaid incentives in 2011.] I think there was a lot of belief that a majority of them should, but that was never congressional intent. The intent was that a minority, maybe a significant minority, would qualify. Part of it is that expectations are out of line. There are organizations that will qualify, even though the bar is high. I also think it was a smart move on the part of the Office of the National Coordinator to set the bar for qualifying high, and then saying: “I know it’s high. But you tell me where to back off and why. So I’m seeking your guidance and counsel.” It’s better to start high and back off than start low—and nobody’s going to force you to go higher, they’ll just force you lower no matter where you start. So I think it was a smart move despite all the [mess] that was created here. I think the other is that providers are sort of under this belief that the federal government ought to cover … Next Page »

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  • http://wellescent.com/health_blog Wellescent Health Blog

    Given the number of private practices, one would think that software as a service (Saas) approaches to EHR access would offer considerable potential. Solving the problem of “meaningful use” for doctors in order to allow access to federal incentives and to prevent payment of penalties would seem to be a fertile area in which to build a business.

  • http://ducknetweb.blogspot.com MedicalQuack

    The adoption of electronic medical records is a complicated issue and party due to the new technology that arrives every week for us to mill over and determine if that needs to be incorporated in to the system. I know I wrote one years ago prior to the big movement to the web, same issue though, just more client/server.

    Secondly until the issues of compensation are settled, it’s a slow go. As the old saying goes nothing happens until the bill gets paid and it’s not the stimulus money that puts meals on the table, it’s the claim revenue and right now there’s many MDs up in the air with a lot going on at once.

    I said we should certify payer algorithms before EHR software a long time ago, as why does one area go through the process without the other side? After all we are back to the money side once again. Certification is important I agree, but again we need ethics on both sides of the table here. Payer algorithm certification should come first as that is what helps keep the rest of the issues up in the air almost single handedly.

    http://ducknetweb.blogspot.com/2010/06/rules-on-ehr-certification-should-take.html

    Further more on health literacy and with patient involvement, we need role models and everyone has health so we all need to participate and role models at the top can create an atmosphere of trust too, we don’t have that.

    http://ducknetweb.blogspot.com/2010/06/hhs-national-plan-to-improve-health.html

    I know I try to speak out pretty plainly as best I can, but when I see the same companies that are paying claims for 15 years of underpayments to doctors and patients being praised and trusted for their analytic, does that not make one wonder how they do business.

    http://ducknetweb.blogspot.com/2010/06/for-top-program-combines-prototype-from.html

    Anyway, if you add this side up to the big nest of non trust and non participants making rules and laws, no wonder so many doctors are skeptical and just seeing what I have from my small corner in life, there’s good reason as nobody appears to be earning any trust around here or making any real efforts to be mentors or role models for anyone else.

    I like technology and what it does and I know electronic medical records are the answer but the other sides of the issues are the obstacles that are holding up the show and prevent real progress.

  • Saumitra

    I agree with Wellescent. May be cloud computing companies could may a foray into EHRs. By the way, I liked this candid interview. Many wouldnt have dared to ask him how he did get kicked out !